الفهرس 
Anatomy of Cervical RegionOnly 14 pages are availabe for public view
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Abstract
C
ervical spondylosis is a common progressive disorder of the ageing cervical spine, it is characterized by degenerative changes affecting the intervertebral discs, vertebrae, facet joints, and ligamentous structures around the cervical spinal canal.
Symptoms of cervical spondylosis may appear in those as young as 30 years and are most commonly in those aged 40-60 years. Radiological spondylotic changes increase with patient age. On the basis of radiologic findings, 90% of men older than 50 years and 90% of women older than 60 years have evidence of degenerative changes in cervical spondylosis.
Mesotherapy is a technique used to inject active substances into the superficial layer of the skin. The objective of this type of administration is to modulate the pharmacokinetics of the injected substance and to prolong the pharmacological effects at a local level. One of the main advantages of mesotherapy is that a local pharmacological effect can be obtained without the need for high systemic concentrations.
It was demonstrated that intradermal injections of small amounts of active substance where the injection site corresponds to the area of the pathological condition for example, in lower back pain-may provide clinical benefits where other therapies are not available/not effective or cannot be used for whatever reason. In addition, intradermal administration of active substances in combination with other systemic therapies can produce synergistic effects, and as a result mesotherapy may have dose-sparing effects.
This thesis was carried out to evaluate the effectiveness of mesotherapy as a technique of local administration for pain relief in cases of chronic cervical pain due to cervical spondylosis versus the effect of oral NSAIDs.
The study included 30 patients with chronic neck pain due to cervical spondylosis (more than 6 weeks) aged between 30 and 60 years old. All patients and controls were subjected to history taking, clinical examination, neurological examination, and Investigations as CBC, ESR, CRP, Liver function tests, Kidney function tests, Antinuclear Antibody (ANA), Rheumatoid factor test (RF), Cervical plain X-ray Pain. Pain and functional assessment using VAS, MPQ, NDI and Northwick Park Neck Pain Questionnaire.
All the patients divided randomly into two groups: Group I who received mesotherapy injection. Group II who received oral NSAIDs.
The present study revealed:
• No significant difference between the two groups as regards sex, age and duration of illness.
• There was significant difference between group I and group II as regard VAS score.
• VAS score reduction percent was significantly higher among group I than group II.
• McGill score, NDI score, North Wick score and tenderness grade are significantly decreased in both groups but the reduction was non-significant in group I than in group II as regard McGill score, NDI score and tenderness grade although North Wick score reduction was significant in group I than in group II.
• No significant difference regard ROM grade, Muscle power grade and clinical reflex grade between the two groups.
• In comparison between males and females regarding change in clinical scores between both groups, VAS reduction was significantly higher in males than females among group I.
• In correlation between age, duration of illness and the change in clinical scores among two groups there was significant negative correlation between age and improvement of tenderness in group II.
In conclusion, the present study showed that the administration of NSAIDs via mesotherapic technique can provide the same therapeutic benefit as that induced by oral drug administration despite the lower amount of drugs administered to patients undergoing mesotherapy and the low frequency of administration. Indeed, both treatments significantly reduced pain intensity, and disability in daily life activity, and improved ROM. Mesotherapy was easily and quickly carried out, well-tolerated, with no local or allergic reactions. The low dose of NSAIDs injected, decreased the drug side effect and work loading on liver and kidney.
Mesotherapy, due to its safety, tolerability, cost effectiveness and efficacy, can be considered a useful technique for the management of painful musculoskeletal diseases and it seems to represent an alternative therapeutic technique especially in the presence of acute, chronic diseases, or comorbidities where there is a high risk of drug interaction, polypharmacy, or when conventional (oral or parenteral) NSAIDs use is contraindicated. Mesotherapy may provide clinical benefits where other therapies are not available/not effective or cannot be used for whatever reason.